Pain can be the symptom of several different gynecological conditions including endometriosis, adenomyosis, and ovarian cysts.
Pain is not a symptom of the hormonal condition PCOS.
But what if you have pain and your doctor discovered polycystic ovaries on ultrasound? Surely, that offers some kind of explanation? No, your pain is not related to that ultrasound finding.
Here are three things to understand.
Polycystic ovaries are not the same as ovarian cysts
Your ovaries are filled with ovarian follicles, and follicles are essentially small, normal “cysts.” Every month, those normal cysts grow, burst, and are reabsorbed. Occasionally, there is a glitch, and one of your follicles can become abnormally large and fluid-filled, forming an abnormal ovarian cyst. Such a cyst can be painful and may require surgery.
The multiple small “cysts” of polycystic ovarian syndrome (PCOS) are completely different. They are not abnormally large follicles. Instead, they are abnormally small follicles that are in a state of partial development. In a way, they’re the opposite of an ovarian cyst.
The number and size of your follicles change every month. So you could have polycystic ovaries one month, but not the next. And you could have polycystic ovaries when everything is normal and fine with your hormones.
The ultrasound finding of polycystic ovaries cannot be used to diagnose the hormonal condition PCOS.
PCOS (polycystic ovarian syndrome) is a hormonal condition
PCOS is a hormonal condition that is defined by two main symptoms:
- Irregular periods and failure to ovulate.
- Elevated androgens or male hormones.
If you have PCOS, then you need treatment to regain ovulation and reduce androgens. That’s what metformin or a no-sugar diet can do, and that’s why they (for example) can help the classic insulin-resistant type of PCOS. Those treatments will do nothing for pain.
You can have both PCOS and pain but they’re separate issues
PCOS is common. But so is period pain and so is endometriosis that can cause severe pain.
It is possible to have both PCOS and period pain.
If your pain is mild, then it should respond to the simple treatments discussed in my period pain post.
If your pain is severe, then please look beyond your PCOS diagnosis to find out what’s really going on. Please read When Period Pain Is Not Normal.
⚠ Tip: Yes, the pill can suppress the symptoms of both PCOS and period pain, but that does not mean it’s fixed either problem.
I hope this post clears up some confusion. Please comment and share your story so others can learn from your experience.